New Delhi: Non-communicable diseases (NCDs) majorly contribute to loss of life years in India with an unequal distribution across states, according to the national disease burden estimates compiled by Indian Council of Medical Research (ICMR).
The study titled "National Burden Estimates of healthy life lost in India 2017", also published in the Lancet, took into account the disability-adjusted life years (DALYs), a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death.
The report has revealed that top 15 conditions that accounted for the most DALYs at all ages arose mostly from Years of Life Lost (YLLs)—namely, ischaemic heart disease (9.6% of all DALYs), perinatal (among newborns) conditions (8.5%), chronic respiratory diseases (5.7%), diarrhoea (4.7%), respiratory infections (4.5%), cancer (4.0%), stroke (3.6%), road traffic injuries (3.3%), tuberculosis (3.1%) and liver and alcohol-related conditions (3.0%).
Pointing out a variation of disease burden across states, the study said, “Among NCDs, cancer YLLs were particularly high in northeastern states, Uttar Pradesh, Rajasthan, West Bengal, Haryana, Assam, Gujarat and Madhya Pradesh, and in the southern states of Kerala and Karnataka but the YLLs from specific causes of cancer varied even within those states with high cancer burden."
“These high-burden states accounted for 44% of national YLLs from cancer. Chronic respiratory YLL rates were high in Rajasthan and Uttar Pradesh, accounting together for 7% of national YLL totals. Liver and alcohol-related YLL rates were high in the northeastern states, Assam, Bihar, Karnataka, and Maharashtra, accounting for 18% of national YLLs. Suicide YLL rates were highest in the southern states, accounting for 15% of national totals," it said.
The study also highlighted that road traffic injuries were high in the northern states of Uttar Pradesh, Punjab, Uttarakhand, Haryana and Himachal Pradesh, accounting for 33% of national totals. Drowning YLL rates were highest in the central states of Madhya Pradesh and Chhattisgarh and in Assam in the northeast, accounting for 11% of national totals.
The authors observed that death by suicide was common in southern India. Young adults are taking their lives at an alarming rate compared to the north, and a previous Million Death Study paper corroborated these results.
“Other findings demonstrated that cancers were more concentrated in the north. DALY rates in rural areas were at least twice those of urban areas for chronic respiratory disease, diarrhea and fevers of unknown origins," Geetha R Menon, Scientist with the ICMR said.
For calculating the disease burden, the researchers used the national-level population and mortality data for 2017 from the UN Population Division and state-level population and mortality data for 2010–17 from the Registrar General of India’s Sample Registration System.
Balram Bhargava, Secretary, Department of Health Research and Director General, ICMR on the preparation and publication of National Burden Estimates (NBE) said that “Locally constructed health statistics help to improve a country’s health policies better. The Government of India seeks to create an understandable and locally applicable metrics for measuring health. ICMR is also the lead partner for GBD India estimates."